| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SVCS INC. | 1520 5TH AVE STE 1500 SEATTLE, WA 98101 | DELTA DENTAL INSURANCE COMPANY | $3K | — | $3K | 1.78% |
| LEAVITT GROUP3 Filed as: LEAVITT GREAT WEST INS SERVICES LLC | PO BOX 2518 BILLINGS, MT 59103 | DELTA DENTAL INSURANCE COMPANY | $2K | — | $2K | 1.22% |
| LEAVITT GROUP3 Filed as: LEAVITT GREAT WEST INSURANCE SRVS L | 2345 KING AVE W #E BILLINGS, MT 59102 | AMERICAN FIDELITY ASSURANCE COMPANY | $4K | — | $4K | 4.04% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SVCS INC. | 1420 5TH AVE STE 1500 SEATTLE, WA 98101 | AMERICAN FIDELITY ASSURANCE COMPANY | $6 | — | $6 | 0.01% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SVCS INC | PO BOX 25181420 5TH AVE STE 1500 BILLINGS, MT 59103 | HARTFORD LIFE AND ACCIDENT | $2K | $289 | $2K | 6.12% |
| LEAVITT GROUP3 Filed as: LEAVITT GREAT WEST INS | PO BOX 2518 BILLINGS, MT 59103 | HARTFORD LIFE AND ACCIDENT | $1K | — | $1K | 4.86% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SVCS INC | 1420 5TH AVE STE 1500 SEATTLE, WA 98101 | HARTFORD LIFE AND ACCIDENT | $907 | $168 | $1K | 5.99% |
| LEAVITT GROUP3 Filed as: LEAVITT GREAT WEST INS | PO BOX 2518 BILLINGS BILLINGS, MT 59103 | HARTFORD LIFE AND ACCIDENT | $887 | — | $887 | 4.94% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUE CROSS BLUE SHIELD OF MONTANA EIN 36-1236610 TPA | Contract Administrator Service code 13 | — | $114K |
Benefits declared on the Form 5500 main form (✓ = also has a Schedule A insurance contract; otherwise the benefit is funded out of plan assets or via a Schedule C TPA).
The plan reports several different headcounts depending on which form you read. Each one measures a different slice of the population.
| Active participants | 271 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 271 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | AMERICAN FIDELITY ASSURANCE COMPANY | 72 | $97K |
| Dental | DELTA DENTAL INSURANCE COMPANY | 419 | $151K |
| Life insurance | HARTFORD LIFE AND ACCIDENT | 271 | $29K |
| Short-term disability | AMERICAN FIDELITY ASSURANCE COMPANY | 72 | $97K |
| Long-term disability(2 contracts, 2 carriers) | AMERICAN FIDELITY ASSURANCE COMPANY | 72 | $115K |
| Other(2 contracts, 2 carriers) | AMERICAN FIDELITY ASSURANCE COMPANY | 271 | $126K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 419 | — |
Why the numbers differ. Form 5500 line 6 counts employees + retirees + beneficiaries; no dependents. Schedule A persons-covered counts everyone enrolled, including spouses and children, so it usually exceeds line 6 by 30-60% on a working-age workforce. The medical row is normally the broadest single line because it has the highest take-up; dental/vision/life often dip below it. Stop-loss / reinsurance contracts sometimes report the carrier's full underwriting pool rather than this filer's headcount; the row is shown for transparency but shouldn't be read as "people in this plan."
No prospect flags tripped on this filing.